Prilocaine
Indications
Prilocaine is used for:
Local Anesthesia
Adult Dose
Local Anesthesia
Dental infiltration: 40-80 mg (1-2 mL) of 4% solution prilocaine or prilocaine with epinephrine
Not to exceed 600 mg (8 mg/kg) within 2 hr
Child Dose
Local Anesthesia
< 10 years
Dental infiltration: 40 mg of (1 mL) 4% solution; not to exceed 8 mg/kg within 2 hr
> 10 years
Dental infiltration: 40-80 mg (1-2 mL) of 4% solution prilocaine or prilocaine with epinephrine; not to exceed 600 mg (8 mg/kg) within 2 hr
Renal Dose
Administration
Contra Indications
Hypersensitivity to prilocaine, amide-type local anesthetics, sulfites, parabens
Idiopathic or congenital methemoglobinemia
Precautions
Administration of >600 mg to adults causes non-acute 15% methemoglobinemia via formation of o-toluidine metabolite
Use preservative-free preparations for spinal or epidural anesthesia
DO NOT use solutions with epinephrine in distal areas of body (e.g. digit, nose, ear, etc)
History of malignant hyperthermia
Respiratory arrest reported with local anesthetics
Seizures reported with systemic toxicity
Addition of vasoconstrictor, epinephrine, will promote local hemostasis, decrease systemic absorption, and increase duration of action
Pregnancy-Lactation
Pregnancy Category: C
Lactation: not known if excreted in breast milk
Interactions
Adverse Effects
Side effects of Prilocaine :
Frequency Not Defined
CNS depression manifested by drowsiness, unconsciousness, respiratory arrest, nausea, vomiting, chills, miosis, tinnitus; myocardial depression, bradycardia, cardiac arrhythmias, hypotension, cardiovascular collapse, cardiac arrest; palpitation, headache, tremors, tachycardia, anginal pain, hypertension (epinephrine-containing solutions)
Anxiety
Apprehension
Restlessness
Nervousness
Disorientation
Confusion
Dizziness
Blurred vision
Tremors
Twitching
Shivering
Seizures
Edema
Status asthmaticus
Anaphylactoid reactions (sometimes fatal)
Mechanism of Action
Local anesthetics prevent generation/conduction of nerve impulses by reducing sodium permeability and increasing action potential threshold